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Contact Information

COMMONWEALTH PHYSICIAN NETWORK LLC
610 WYOMING AVE
KINGSTON, PA18704-3702
 Phone: 570-288-5441
 Fax: 570-288-9613
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Surgery

208600000X 02 Physician/General Surgery
 

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for COMMONWEALTH PHYSICIAN NETWORK LLC

NPI # 1003238635
LBN Legal business name COMMONWEALTH PHYSICIAN NETWORK LLC
Authorized official KRISTINA MUSIC - (DIRECTOR PROVIDER ENROLLMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/16/2014
Last updated 07/09/2025 - About 11 months ago
Identifiers
PA Medicaid 102897748 0001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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